Organization
CHANG ADVANCED CHIROPRACTIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KI WON CHANG (CLINIC PRESIDENT)
(703) 916-0303
Entity
Organization
Contact information
Practice address
7004 LITTLE RIVER TPKE, SUITE C, ANNANDALE, VA 22003-3201
(703) 916-0303
Mailing address
7004 LITTLE RIVER TPKE, SUITE C, ANNANDALE, VA 22003-3201
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556012
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G01094
MEDICARE PTAN
—
Enumeration date
08/20/2009
Last updated
08/20/2009
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